There is a growing and robust consumer-oriented outpatient marketplace. Venues for care now include urgent cares, primary care variants, and free-standing ER’s, amongst others. Patient demand for convenience and access is driving the growth. This decentralization of access is disruptive to the age old general practioner-specialist care team paradigm. As a result, patients accessing these decentralized points of care are often not evaluated in a continuum that can address chronic disease and provide more preventative care solutions. In a value based healthcare model, this is problematic.
Patients often seek care at these venues for specific acute episodes of illness or injury. Typically, the patient’s episodic need is addressed and they are sent home; until the need for the next episode of care presents itself. Such acute episodic care venues are likely here to stay due to patient demand. It is projected that by year 2020, more patients will receive their “primary care” at these outlets rather than more traditional office based visits.
It is well documented that ER visits are not only costly, but they also typically fall short of providing comprehensive care for health issues outside of the patient’s chief complaint. In a system of care that is going to reward physicians and hospitals based on metrics such as readmissions and other clinical indicators, we are going to need a solution to connect chronic disease management to convenient care outlets. Patients with chronic diseases such as hypertension, diabetes, COPD, and cardiovascular disease that receive care at these venues present a new challenge for how to incorporate these “doc in a box” models into the healthcare value chain.